Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

Thousands of members of the support group Taking Off Pounds Sensibly, or TOPS, are in the Steel City this week for their international convention. Founded more than 50 years ago at a homemaker’s kitchen table, the nonprofit group boasts 235,000 members at more than 10,000 chapters in the United States and Canada.

But unlike popular diet plans that tell you want to eat, TOPS emphasizes support.

“It was like having another family,” said Beverly Enos, of Georgetown, Mass., who has been a member since 1970. “TOPS is very much a support group. There is no one lecturing, telling you what to do.”

Enos, 54, joined the program in Japan while living on a military base. She lost 70 pounds, and has kept it off for more than 25 years.

“I was going to the gym and stuff, but I needed to lose the weight and I couldn’t do it alone. Alone I gained, so I needed to do it with people,” Enos said.

About two-thirds of American adults are overweight or obese. Obesity, which is linked to diabetes, heart disease and other ailments, is on pace to beat smoking as the nation’s leading cause of preventable death.

A range of diets practiced
Though TOPS encourages members to follow healthy eating guidelines established by the American Dietetic Association, its members practice various weight-loss methods, everything from following low-carb diets to having bariatric surgery, commonly referred to as stomach stapling.

“What we’re about is support, and that never goes out of style,” said Melissa Baxter, the Milwaukee-based group’s spokeswoman.

TOPS is also affordable, costing $20 a year to join. By comparison, Weight Watchers, one of the best-known weight-loss and support programs, charges up to $12 a week, depending on location, and a one-time registration fee. Both TOPS and Weight Watchers have weekly meetings, with Weight Watchers claiming about 46,000 meetings worldwide.

TOPS participants are encouraged to work out a nutritional plan with their doctors. Each week, they weigh in and discuss why they gained or lost weight. There is also online help, with chat rooms and “e-mail pals” that offer encouragement.

“It may not be all the support you need, but it’s always helpful in weight loss to have someone who you can be accountable to,” said Cathy Nonas, an ADA spokeswoman and director of Obesity and Diabetes programs at North General Hospital in New York City.

TOPS was started in 1948 by Esther Manz, a Milwaukee homemaker who was pregnant with her fifth child. Manz figured the support she was getting at childbirth classes might also help her lose weight. So, using the public bus system, she traveled around the city helping set up chapters of her group.